摘要
目的 探讨基于系统炎症反应指数(SIRI)和甘油三酯葡萄糖指数(TYG)的列线图模型对急性心肌梗死患者PCI术后发生主要不良心血管事件(MACE)的预测价值。方法 选取2021年1月-12月新疆医科大学第一附属医院心脏中心收治的188例急性心肌梗死患者作为研究对象,按患者PCI术后1年内是否发生MACE分为MACE组47例和N-MACE组141例,比较两组急性心肌梗死患者一般临床资料、实验室相关指标、SIRI以及TYG水平,多因素Logistic回归分析获得影响急性心肌梗死患者PCI术后发生MACE的独立预测因素,基于独立预测因素构建预测急性心肌梗死患者PCI术后发生MACE风险概率值的列线图模型,绘制校准曲线、ROC曲线和决策曲线,分析独立预测因素以及联合预测的预测效能和净收益率。结果 多因素Logistic回归分析结果显示,TYG、2型糖尿病以及SIRI为影响急性心肌梗死患者PCI术后发生MACE的独立预测因素(P<0.05);基于独立预测因素构建列线图模型拟合优度(H-L)检验结果显示,急性心肌梗死患者PCI术后发生MACE的预测值与实际观测值符合度良好(P>0.05);ROC分析显示,TYG、2型糖尿病、SIRI以及联合预测急性心肌梗死患者PCI术后发生MACE的曲线下面积(AUC)分别为0.718(95%CI:0.679~0.938)、0.825(95%CI:0.752~0.938)、0.731(95%CI:0.709~0.962)以及0.876(95%CI:0.830~0.978),TYG和SIRI的最佳诊断截点分别为1.7及2.0;决策曲线分析结果显示,在大多数高风险阈值范围内,联合预测急性心肌梗死患者PCI术后发生MACE的净收益率高于TYG、2型糖尿病以及SIRI。结论 基于TYG和SIRI的列线图模型能用于准确预测急性心肌梗死患者PCI术后发生MACE风险。
Objective To investigate the predictive value of nomogram model based on systemic inflammatory response index(SIRI)and triglyceride glucose index(TYG)for major adverse cardiovascular events(MACE)in patients with acute myocardial infarction after PCI.Methods From January to December 2021,a total of 188 patients with acute myocardial infarction admitted to the Heart Center of the First Affiliated Hospital of Xinjiang Medical University were included as subjects in the research.According to whether MACE occurred within 1 year after PCI,the patients were divided into MACE group(n=47)and N-MACE group(n=141).The general clinical data,laboratory related indicators,SIRI and TYG levels of the two groups of patients with acute myocardial infarction were compared.Multivariate Logistic regression analysis was used to obtain independent predictors of MACE in patients with acute myocardial infarction after PCI.Based on independent predictors,a nomogram model was constructed to predict the risk probability of MACE after PCI in patients with acute myocardial infarction.The calibration curve,ROC curve and decision curve were drawn to analyze the independent predictors and the predictive efficacy and net rate of return of combined prediction.Results Multivariate logistic regression analysis showed that TYG,type 2 diabetes mellitus and SIRI were independent predictors of MACE in patients with acute myocardial infarction after PCI(P<0.05).The goodness-of-fit(H-L)test results of the nomogram model based on independent predictors showed that the predicted value of MACE after PCI in patients with acute myocardial infarction was in good agreement with the actual observed value(P>0.05).ROC analysis showed that the area under the curve(AUC)of TYG,type 2 diabetes mellitus,SIRI and combined prediction of MACE after PCI in patients with acute myocardial infarction were 0.718(95%CI:0.679-0.938),0.825(95%CI:0.752-0.938),0.731(95%CI:0.709-0.962)and 0.876(95%CI:0.830-0.978)respectively.The optimal diagnostic cut-off points of TYG and SIRI were 1.7 and 2.0,respectively.The results of decision curve analysis showed that in most high-risk threshold ranges,the net return rate of combined prediction of MACE after PCI in patients with acute myocardial infarction was higher than that of TYG,type 2 diabetes mellitus and SIRI.Conclusion The nomogram model based on TYG and SIRI can be used to accurately predict the risk of MACE after PCI in patients with acute myocardial infarction.
作者
尼罗菲尔·艾尔肯
菲尔东·阿布力孜
印婷婷
盖娟
范平
Niluofeier·Aierken;Feierdong·Abulizi;YIN Tingting;GAI Juan;FAN Ping(Department of Cardiac Function,Heart Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China;Department of Pain,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi 830000,Xinjiang,China)
出处
《医学信息》
2026年第3期48-52,共5页
Journal of Medical Information
基金
新疆维吾尔自治区区域协同创新专项——科技援疆计划(编号:2022E02111)。
关键词
急性心肌梗死
主要不良心血管事件
系统炎症反应指数
甘油三酯葡萄糖指数
列线图模型
Acute myocardial infarction
Major adverse cardiovascular events
Systemic inflammatory response index
Triglyceride glucose index
Nomogram model
